Monthly Archives: June 2016

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A Washington State appeals court has held that a high school should have been more compliant with a state law pertaining to concussions after one of its football players, who suffered multiple concussions, died from those injuries.

The claim was brought by the parents of Drew Swank, who was participating in a game for New Valley Christian School (VCS) on Sept. 18, 2009 when he suffered a head injury that led to severe headaches, and ultimately his death.

Allegedly, Swank was not examined by head coach Jim Puryear, assistant coach Mike Heden, or school headmaster Derick Tabish. But the following Monday, as the headaches persisted, he went to his Coeur d’Alene doctor, Tim Burns.

The doctor diagnosed a concussion and Swank was placed on “no practice, no play” restrictions.

Three days later, Swank told his mother that the headaches were gone. When she called Burns’ office to inform the doctor of the development, the doctor allegedly told a clinic employee to lift the restrictions without a follow-up exam. Swank practiced and then played in a game that night.

Swank played poorly, which the plaintiffs claimed was consistent with a player coming off a head injury. Coach Puryear allegedly called him to the sideline, where he “grabbed him by the facemask and proceeded to violently shake his head up and down in anger,” according to the complaint. Swank went back into the game and suffered a significant hit that caused his head to allegedly whip back and forth before crashing into the field.

Swank managed to get up from the hit, but collapsed after reaching the sideline. He was then rushed to a local hospital, and airlifted to Providence Sacred Heart Medical Center in Spokane, where he died four days later.

The NCAA’s committee responsible for student-athlete health and safety took steps at its summer meeting to better establish medical personnel as authoritative decision-makers in college sports.

During its meeting June 15-17 in Dallas, the Committee on Competitive Safeguards and Medical Aspects of Sports approved a series of recommendations that build on legislation passed by the NCAA’s five autonomy conferences earlier this year and would establish athletic trainers and team physicians as unchallengeable decision-makers for medical management and return-to-play decisions related to student-athletes. The recommendations would also create a new designated position on campuses – an athletics healthcare administrator – which would ensure campuses are following established best practices for medical care.

“Over the last three years, the committee has consistently worked to empower primary athletics health care providers and championed organizational structures that ensure independent medical care for student-athletes,” said CSMAS chair Forrest Karr, athletics director at Northern Michigan University. “These recommendations are another step in the process. We envision a future where each member institution, in all three divisions, will designate an athletics health care administrator responsible for ensuring that their school’s policies and procedures follow inter-association consensus recommendations and comply with all NCAA health and safety legislation.”

The committee crafted its recommendations by working from legislation that was passed by the five autonomy conferences in Division I at the 2016 NCAA Convention. That legislation will take effect Aug. 1 and provides unchallengeable autonomous authority to team physicians and athletic trainers at schools in those conferences to determine medical management and return-to-play decisions related to student-athletes. The remaining conferences in Division I currently have the option of applying that legislation.

The CSMAS recommendations aim to shape the intent of that legislation into a consistent standard across college sports. To get there, CSMAS made three recommendations:

One recommendation encourages leagues outside the autonomy conferences in Division I to apply the autonomous legislation passed in January. The recommendation asks that those conferences opt in to the legislation by Aug. 1, 2017.

A second legislative recommendation asks the Division I autonomous conferences to clarify the bylaw passed in January by changing the name of its oversight position – called a director of medical services in that legislation – to athletics healthcare administrator. The name change was requested out of concern that the position could be confused with the title of “medical director,” which is established elsewhere in NCAA bylaws.

A third recommendation asks Divisions II and III to sponsor legislation similar to that passed by the Division I autonomous conferences to establish the athletics health care administrator position and provide team physicians and athletic trainers with unchallengeable autonomous authority to determine medical management and return-to-play decisions related to student-athletes. The committee stressed that the health care administrator role may be given to an existing staff member rather than create an additional administrative position.

CSMAS recommendations follow those from other organizations in recent years which called for physicians and athletic trainers to have the ability to make medical decisions without fear of interference from coaches or other athletics personnel.

In 2014, the Journal of Athletic Training published interassociation best practices – of which the NCAA’s Sport Science Institute was included as an endorsing organization – which included giving physicians and athletic trainers authority to make medical decisions for student-athletes. That document was published at a time when a national survey conducted by the Chronicle of Higher Education documented that athletic trainers, in particular, function under the heavy influence of the coaching staffs: Thirty-two percent of respondents indicated the head coach influences their hiring; 42 percent reported feeling pressured to return a concussed athlete to play early; and 52 percent reported feeling pressured to return injured athletes early.